Liverpool Care Pathway - This Disgraceful Arrogance

Some doctors are cursed with arrogance; others are blessed with humility. Though one claimed by some, infallibility is not a recognised human trait.


Pulse reports on the Annual Representatives Meeting of the BMA.

This is the infamous motion to back the LCP -

Motion in full

Motion to be proposed by the Harrogate Division:

That this Meeting:

i. notes that recent adverse media coverage has caused some patients and relatives to lose confidence in the Liverpool Care Pathway (LCP);

ii. affirms the value of the Liverpool Care Pathway in delivering excellent end of life care for dying patients;

iii. believes that strategies to implement the LCP must reward quality of care and not the frequency of use;

iv. supports the appropriate use of the Liverpool Care Pathway and palliative care in the UK;

v. asks the BMA to request that teaching in using end of life care pathway to be part of medical school curriculum. 

Even Baroness Ilora Finlay of Llandaff, professor of palliative care medicine at Cardiff University, advised caution. There is, after all, a government review under way. Still, the doctors were persuaded by propaganda and spoof to plunge in to provide their support.

Strategic positioning

This was rather reminiscent of the manner in which the BMA's stance on euthanasia was modified in 2005. By connivance and artifice, that was achieved. That change of stance has enabled all manner of nasties to advance their cause and has pulled the rug from under the feet of those who oppose it. Where was the mandate?

So, do delegates/representatives at the ARM have access to the deliberations of the Review panel that the rest of us - and, mayhap, certain members of the panel! - do not? Or do they hope to pre-empt and, thereby, influence the outcome of those deliberations  by throwing down the gauntlet to its members that they do battle with such an august body as the BMA itself and that is no trifling matter?

The ARM of the BMA is akin to the AGM of any Trade Union in the land. The bulk of it is politics.

Politicians are a notoriously treacherous and untrustworthy breed. Politicised doctors add a whole new dimension to that perspective in an arrogant belief in self-righteous infallibility.

It is an unfortunate characteristic, that is not universal, but is often particular, that these persons do possess a ‘god complex’.

Any profession, the medical profession included, should have as its focus professional matters, the ethics and practice of their profession, and yet, politicians being politicians, this will, and does, overlap into all manner of unrelated areas.

It appears to be a complex amongst certain of these professional people in their rantings abroad the net in support of the LCP and rubbishing its opponents to declare themselves ‘atheist’ - which does seem rather odd of people possessing the most definite traits of the 'god complex'.

What has their personal stance on the existence or non-existence of a divine being to do with the documented facts of a failed and ethically questionable protocol much publicised as such - and rightly so - in the press? It is almost a statement of denial of ethics...

These doctors, when confronted with an argument they cannot immediately answer, will often respond by going on a skew, asking what is the religious standpoint of their antagonist. It is as if the mere fact of professing or possessing such a viewpoint or belief is grounds and just cause sufficient to dismiss the argument.

Such sanctimonious bigotry from those denying any allegiance to a god-head seems, at once, inapposite and yet fitting - when one considers that these persons may possess the 'god complex'!

Such persons do great discredit and disrespect to fellow supporters of the LCP such as Dr. Peter Saunders, CEO of Christian Medical Fellowship.

Dr. Saunders expounds support for the LCP and publicises the matter of his religious affiliation in the same manner that these other doctors expound their a-religious or non-religious affiliation. He does not bring that into his argument in debate on the LCP, however. But then, perhaps, Dr. Saunders does not have a 'god complex'!

Dr. Saunders is a paradigm of the politicised doctor with telescope vision, however.

Thus, even though invited in debate and discussion as CEO of Christian Medical Fellowship on a programme called Everyday Ethics , he could not grasp that significance and purpose of his invite and that of his co-debater, Professor Patrick Pullicino, consultant neurologist at East Kent Hospitals and Professor of Clinical Neurosciences at the University of Kent.

It would seem that some doctors are cursed with arrogance, whilst others are blessed with humility. It would seem that some doctors profess religious or spiritual leanings because of what they are - others, because of WHO they are.

It is noteworthy that politics intrudes to suppress as well as to promote. What happened to this draft proposal? Can anyone enlighten me or advise...?

Bad Guidelines -

Draft motion to the BMA Annual Representative Meeting
We would be grateful if BMA members could consider submitting the following ARM motion via their branch or committee…

‘This conference:

1) Notes BMA motions in 2007 and 2012 that acknowledged the close links between the medical profession and the pharmaceutical industry and stated that these interactions can adversely influence prescribing.

2) Notes that the BMA is signatory to a document produced by the Ethical Standards in Health and Life Sciences Group called Guidance on collaboration between healthcare professionals and the pharmaceutical industry (2012) alongside the Association of the British Pharmaceutical Industry and various medical bodies.

3) Applauds the document’s aim of ‘ethics’ and ‘transparency’ but believes it is flawed for the following reasons

a) The document states that ‘medical representatives’ can be a ‘useful source of information for healthcare professionals’ and that ‘Industry has a valid and important role in the provision of medical education’.

b) The document does not acknowledge the best currently available evidence, a systematic review (Spurling et al, 2010), which shows that doctors who are exposed to information from pharmaceutical companies, such as pharmaceutical sales representative visits and attendance at pharmaceutical sponsored educational meetings, tend to prescribe more frequently, less appropriately and at higher cost than other doctors.

c) The document implies that all industry-sponsored trial data is publicly available, when this is untrue (Goldacre et al, 2013) and access to withheld information about clinical trials is the subject of a prominent on-going campaign, questions in Parliament, and at least one parliamentary select committee enquiry.

4) This conference believes

a) That the BMA should publically withdraw its support for the document

b) That the BMA should advocate for the other signatories to do the same

Spurling GK, Mansfield PR, Montgomery BD, Lexchin J, Doust J, et al. (2010) Information from Pharmaceutical Companies and the Quality, Quantity, and Cost of Physicians’ Prescribing: A Systematic Review. PLoS Med 7(10): e1000352.

Goldacre B, Heneghan C, Godlee F, Chalmers I (2013). Missing trials briefing note. Available from http://www.alltrials.net (accessed 16 January 2013).